AP Literature and Research - The Alert Program · TherapyWorks, Inc PO Box 95316 Albuquerque, NM...

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ALERT PROGRAM® LITERATURE AND RESEARCH: Published Literature, Research, and Resources

Available to print from Research page at www.AlertProgram.com

TherapyWorks, Inc. (TWI) is committed to providing consumers with available evidence, research, and published literature related to the Alert Program®. We hope that families and practitioners will find this published information and objective data helpful to support appropriate use and application of the Alert Program®. This document is updated periodically. The following list of literature, articles and research is organized into four major sections: SECTION I: References Specifically Addressing the Alert Program®……….pp. 2-10

A. Refereed Professional Journals---------------------------------------------- p. 2 B. Professional Newsletter/Magazines------------------------------------------ p. 3 C. Books/Manuscripts/Professional Texts-------------------------------------- p. 7 D. Unpublished Graduate Theses/Dissertations------------------------------- p. 8 E. Popular Press----------------------------------------------------------------- p. 10

SECTION II: Articles on the Effectiveness of Sensorimotor Strategies that Support Self-Regulation, Learning and Living……………………pp. 11-22

A. Refereed Professional Journals---------------------------------------------- p. 11 B. Professional Newsletter/Magazines------------------------------------------ p. 19 C. Books/Manuscripts/Professional Texts-------------------------------------- p. 20 D. Unpublished Graduate Theses/Dissertations------------------------------- p. 21 E. Popular Press----------------------------------------------------------------- p. 21

SECTION III: Select Articles on the Relationship of Self-Regulation to

Learning………………………………………………………………………. pp. 23-24 SECTION IV: Select Articles on the Theory of Sensory Integration………… pp. 25-26 SECTION V: Websites that Provide Additional Support and References… p. 27

ALERT PROGRAM® LITERATURE AND RESEARCH

AVAILABLE AT WWW.ALERTPROGRAM.COM 5/26/15

SECTION I: References Specifically Addressing the Alert Program®

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SECTION I References Specifically Addressing the Alert Program®

A. Refereed Professional Journals

Barnes, K.J., Beck, A.J., Vogel, K.A., Grice, K.O., & Murphy, D. (2003). Perceptions regarding school-based occupational therapy for children with emotional disturbances. American Journal of Occupational Therapy, 57, 337-341. Comment: This study examines the appropriateness, extent and types of services provided by occupational therapists to children with emotional disturbances in public schools. Eighty-seven percent of all respondents supported school OT for students with emotional disturbances. The most commonly reported intervention was sensory integration with nearly 47% using the Alert Program® individually and in groups.

Barnes, K. J., Vogel, K. A., Beck, A. J., Schoenfeld, H. B. & Owen, S. V. (2008). Self-regulation strategies of children with emotional disturbance, Physical & Occupational Therapy In Pediatrics, 28:4, 369-387. Comment: An 8-week-long use of the Alert Program® within the classroom setting for 7 children with emotional disturbances demonstrated improvement on all measures as compared to the control group.

Bertrand, J. (2009). Interventions for children with fetal alcohol spectrum disorders (FASDs): Overview of findings for five innovative research projects. Research in Developmental Disabilities, 30, 986-1006. Comment: This article provides a general intervention framework for individuals with fetal alcohol spectrum disorders (FAS), and the methods and general findings of five specific intervention research studies conducted within this framework. One study, conducted by Children’s Research Triangle of Chicago, developed and evaluated a program of neuro-cognitive habilitation, adapted from the Alert Program®. Results from the 78 children and families studied, suggest the Alert Program® as a promising approach for helping children with FAS improve their self-regulation and executive functioning skills.

Just Added Cohn, E.S., Kramer, J., Schub, J.A. & May-Benson, T. (2014). Parent’s explanatory models and hopes for outcomes of occupational therapy using a sensory integration approach. American Journal of Occupational Therapy, 68, 454-462.

Comment: The importance of parents’ perspectives in identifying and addressing concerns and goals of children who receive occupational therapy using a sensory integration approach was the focus of this research. Two hundred and seventy-five parents, seeking intervention for their children ages 4-11 years of age responded to open-ended questions designed to elicit their hopes and goals for their children’s therapy. Four categories were identified: 1) self-regulation (72%); 2) social participation (42%); motor skills ((40%); and, confidence (39%). Self-regulation was a prominent and overarching concern. The Alert Program® was identified as an intervention to help children self-monitor and self-evaluate performance.

Colangelo, C. (2008). Test Drive: Introducing the Alert Program® through song (Reviews, Tidbits and Tools). Journal of Occupational Therapy, Schools, & Early Intervention, 1:1, 70-71. Comment: The author provides a review of the publication “Test Drive: Introducing the Alert Program® through Song”. From extensive experience as a school-based therapist, the author shares her perspectives on the value and use of the Alert Program® with a school-aged population.

Martin, B.A., & Suane, S.N. (2012). Effect of training on sensory room and cart usage. Occupational Therapy in Mental Health, 28:2. 118-128

Comment: This study focuses on the importance of education in engaging staff and clients in a program facilitating self-regulation. The authors of this study assessed the effectiveness of education on the consistency of use of sensory rooms within a large mental health facility. Eleven staff and thirty-six clients participated. Results were significantly significant in supporting the effectiveness of training using hands-on, population specific strategies.




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Just Added Mac Cobb, S., Fitzgerald, B. & Lanigan-O’Keefe, C. (2014). The Alert Program for self- management of behavior in second level schools: results of phase 1 of a pilot study, Emotional and Behavioural Difficulties, 19:4, 410-425. Retrieved October 2014 from http//dx.doi.org/10.1080/13632752.2014.903593

Comment: Eighty-five students (aged 12-13 years) and four teachers were involved in this study. The students were from schools in areas of social disadvantage (in Ireland) and presented with challenging social, emotional, behavioral, and learning difficulties. The Alert Program® was used as a framework for the study. This first phase was occupational therapist led with class teacher support. Students gained an understanding of their challenging behaviors and identified strategies to support themselves in the classroom. The group of students perceived to be the most challenging gave the most positive scores, and 100% of these students indicated an intention to use their new strategies in class. Positive results of this study have lead to the second phase where teachers take the lead role.

Just Added Mac Cobb, S., Fitzgerald, B., Lanigan-O’Keefe, C., Irwin, N., & Mellerick, N. (2014). Students with social, emotional, and behavioral difficulties: The Alert Program trial in post-primary schools. Journal of Occupational Therapy, Schools, & Early Intervention, 7:2, 106-119. Retrieved November 2014 from http//dx.doi.org/10.1080/19411243.2014.930606

Comment: This article describes the collaborative project involving teachers and occupational therapists in implementing an adapted version of the Alert Program® in four Irish schools in areas of social disadvantage during the 2011-2012 academic year. Eighty-five students participated with positive results. Reportedly, the most challenging students were the most positive about the program. Self-management was enhanced resulting in greater self-efficacy in those students with a history of low achievement in school. A whole-school approach was recommended based on the positive results obtained.

Wells, A.M., Chasnsoff, I.J., Schmidt, C.A., Telford, E., & Schwartz, L.D. (2012). Neurocognitive habilitation therapy for children with fetal alcohol spectrum disorders: An adaptation of the Alert Program®. American Journal of Occupational Therapy, 66, 24-34. Comment: This study evaluates the effectiveness of a neurocognitive habilitation program, integrating components of the Alert Program® with interventions used in therapy for traumatic brain injury, for foster and adoptive caregivers and their children who were prenatally exposed to alcohol. The program is grounded in the premise that difficulties with self-regulation contribute to the daily challenges experienced by this population of children. The study involved 40 children in the treatment group and 38 children in the control group (aged between 6 years to 11 years, 11 months). Results revealed that children in the intervention group demonstrated significant improvements in executive and emotional functioning when compared with the control group. This study provides information about sensory integration and executive functioning needs of children with prenatal alcohol exposure and explains a valuable role for occupational therapy in adapting the Alert Program® with this population while working with caregivers and families.

B. Professional Newsletter/Magazines

AA Digest Staff. (2007, September/October). Interview: Meet the Alert Program® founders. Autism-Asperger’s Digest Magazine, 42-43. Comment: This article presents a summary of an AA Digest interview with the Alert Program® creators Sherry Shellenberger, OTR and Mary Sue Williams, OTR.

AA Digest Staff. (2002, May-June). Featured Book: Take Five! Staying alert at home and school. Autism-Asperger’s Digest Magazine, 24-26. Comment: The Take Five! publication is featured with portions of the text quoted and resources provided.

Argabrite Grove, R. E. (2002, March 25). Embracing our psychosocial roots. OT Practice, 21-25. Comment: The Alert Program® is described as one of several valuable tools available to the OT when addressing psychosocial issues of a child in school-based practice.




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Barnes, K., Schoenfeld, H., Garza, L., Johnson, D., & Tobias, L. (2005, June). Preliminary: Alert Program® for boys with emotional disturbances in the school setting. American Occupational Therapy Association School System Special Interest Section Quarterly, 12, 1-4. Comment: This newsletter article presents results of a pilot study using the Alert Program® with children with emotional and sensory processing problems.

Bazyk, S. (2010, September 27). Promotion of positive mental health in children and youth with developmental disabilities. OT Practice, CE-1-8. Comment: Presents opportunities for OT practitioner to provide activities that promote mental health in children and youth with developmental disabilities. An overview of strategies for promotion, prevention and intervention is presented. The use of the Alert Program® for promotion and prevention is suggested.

Bazyk, S., Schefkind, S., Brandeburger Shasby, S., Olson, L., Richman, J., & Gross, M. (2008) FAQ on school mental health for school-based occupational therapy practitioners. Retrieved September 3, 2009, from AOTA Web site: www.aota.org/.../PracticeAreas/Pediatrics/Tools/FAQSchoolMH.aspx Comment: The role of the OT is described in advancing school mental health (SMH). The Alert Program® is presented as a sensory processing approach that assists practitioners in identifying sensory preferences and strategies to enhance attention, behavioral organization and everyday functioning.

Cahill, S.M. (2006). Classroom management for kids who won’t sit still and other “bad apples”. Teaching Exceptional Children Plus, 3(1) Article 6. Retrieved July 25, 2007, from http://escholarship.bc.edu/education/tecplus/vol3/iss1/art6/ Comment: Describes collaboration between a school-based occupational therapist and a veteran expert teacher in applying the Alert Program® to an entire classroom. It concludes with how the Alert Program® became an effective classroom management system.

Chinnock, L. & Matson, R. (2013, August). Sensory strategies. OT News (UK), 36-37.

Comment: The authors describe the application of the Alert Program® within female rehabilitation psychiatric units in England. The initial pilot was targeted to a group of female patients with a diagnosis of personality disorder who exhibited self-harming behaviors. The authors describe the process of training OTs within a private mental health service and strategies for supporting the therapists’ learning and confidence for implementing this approach within their respective facilities. While the introduction to this approach is still in its infancy, positive results have become increasingly apparent for patients and staff alike.

Dolde, K. (2008, September). Sensory challenges and sensory solutions for children and caregivers. News-line for Occupational Therapists & COTAs, 7(9F). Retrieved October 1, 2008, from www.news-line.com. Comment: Describes an occupational therapist’s, Christy Kennedy, OTR/L, application of the Alert Program® with children in her private practice in Decatur, Georgia. Anecdotal information provided.

Feldman, J.S. (2012, August 13). Treating pre-adolescents with anxiety disorders: Using cognitive-behavioral and sensory-integrative approaches for self-regulation. ADVANCE for Occupational Therapists, 17.

Comment: This author presents a cognitive-behavioral and sensory integrative intervention approach that she has successful applied to pre-adolescent children with a primary diagnosis of anxiety disorders. The modified Alert Program® and The Incredible 5-Point Scale by Kari Dunn Buron and Mitzi Curtis were found to be successful tools in helping these children gain critical self-knowledge and skills in dealing with self-regulation.




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Feldman, J.S. (2012, August 13). Treating pre-adolescents with anxiety disorders: A case study using sensory-motor interventions to teach 10-year-old Courtney to regulate her anxiety. On-line Extras/ADVANCE for Occupational Therapists. Retrieved August 12, 2013, from http://occupational-therapy.advanceweb.com/Web-Extras/Online-Extras/Treating-Pre-Adolescents-with-Anxiety-Disorders.aspx

Comment: This case study follows the August 13 ADVANCE print edition and provides an excellent description of the author’s application of the Alert Program® concepts to a 10 year old child. The author shares how her intervention included the entire family and the importance of facilitating the use of therapeutic strategies at home, school and during leisure activities. This case demonstrates the role of occupational therapy (OT) in addressing self-regulation for this population and how OT can be an important piece of an integrated approach to helping children with an anxiety disorder.

Kerr, T. (1995, March 6). How Does Your Engine Run?®. ADVANCE for Occupational Therapists, 12, 50. Comment: Provides an overview of the Alert Program®, including the program’s development and application.

Laurel, M. (1997, August 18). Changing level of alertness to enhance life success. ADVANCE for Speech-Language Pathologists & Audiologists, 7, 10. Comment: This article is written from a Speech and Language Pathologist’s perspective and includes an overview of the Alert Program®.

Laurel, M. (2000, March/April). Bringing sensory integration home: A parent perspective on the Alert Program® for Self Regulation. Autism/Asperger’s Digest Magazine, 14-15. Comment: Describes a touching story from a parent’s perspective using the Alert Program®, along with a one-page summary of the program.

Maas, C., Mason, R., & Candler, C. (2008, Oct. 20). “When I get mad….” An anger management and self-regulation group. OT Practice, 9-14. Comment: Describes the development and outcome evaluation of a collaborative interdisciplinary anger management/self-regulation program implemented to a group of children in the public schools. The Alert Program®, was chosen due to its success with children who demonstrate sensory processing/modulation problems.

Moran, J. & Motin, B. (2011, December 19). Ready, set, learn. ADVANCE for Occupational Therapists, 22-23. Comment: The use of an adapted Alert Program® in a classroom environment is described with specific activities cited and the role of the occupational therapist identified. Special considerations and outcomes are presented.

Nalley, C. (2013). The engine that could: Since its humble beginning two decades ago the Alert Program has become an internationally recognized resource. Advance for Occupational Therapy Practitioners. Retrieved January 30, 2013, from http://occupational-therapy.advanceweb.com/Editorial/Content/PrintFriendly .aspx?CC=263163

Comment: Author provides an historical overview of the role and influence that the Alert Program® has had over the past two decades. Its humble beginnings, the basis for the program’s success, the body of research that has emerged, international growth and future development are all addressed.

Pliscofsky, G. & Cashriel, C. (2006, Oct. 16). Playing together. ADVANCE for Occupational Therapists, 22-23. Comment: Describes a preschool play therapy group where the Alert Program® was incorporated.

Rynaski, H. (1994, November 24). How Does Your Engine Run? OT Week, 8, 20-22. Comment: Describes Williams and Shellenberger’s work in the Gallup NM Public Schools, the development of the Alert Program® and an overview of the program.




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Salls, J. & Bucey, J. (2003, March 10). Self-regulation strategies for middle school students. OT Practice, 11-16. Comment: Describes incorporation of the Alert Program® into a middle school curriculum.

Samelstad, K. & Hacker, C. (1996, December 5). How Does Your Engine Run? OT Week, 10. 14-15. Comment: Describes two occupational therapists’ successful experiences using the Alert Program® in a Michigan school and in a North Carolina private practice.

Sarracino, T., Dell, L. & Milchick, S. (2002, January 14) Autism spectrum disorders: Integrating methodologies and team efforts. OT Practice, 13-17. Comment: Highlights some of the key elements of strategies used by occupational therapists when working with children with autism. The Alert Program® was referenced as a means to help children maintain optimal levels of arousal and attention.

Schaefer, 1. (2011, December 5). Check your engine. ADVANCE for Occupational Therapy Practitioners, 24. Comment: The author describes an innovative educational strategy for communicating with the community. A description of a “sensory fair” implemented for a local school is provided and benefits for the endeavor are discussed.

Schoonover, J. (2002, September 16). Teaching social skills. In Y. Swinth & B. Hanft (eds), School-based practice: Moving beyond 1:1 service delivery. OT Practice, 18-19. Comment: A case example is provided to demonstrate how the Alert Program® may be used to improve social skills of children in a school-based program.

Scott, K.W. (2010, June 28). My sensory world. OT Practice, 18-20. Comment: Author emphasizes the important contribution of occupational therapy practitioners in helping clients learn and practice strategies to help regulate fragile nervous systems. The Alert Program® is introduced as a option for intervention.

Stancliff, B. (1998, December). OT can help parents and teachers deal with ADHD: Understanding the “whoops” children. OT Practice, 18-25. Comment: Defines ADHD using a case study perspective. One of the treatment modalities discussed is the Alert Program®.

Williams, M.S. & Shellenberger, S. (1994, September). The Alert Program™ for self-regulation. American Occupational Therapy Association Sensory Integration Special Interest Section Newsletter, 17, 1-3. Comment: This four page detailed article is designed to give occupational therapists a comprehensive summary of the Alert Program® and gives excerpts from the Leader’s Guide and Introductory Booklet.

Williams, M.S. & Shellenberger, S. (2000, March). How Does Your Engine Run? The Alert Program™ for Self-Regulation. Autism-Asperger's Digest Magazine, 14. Comment: Provides brief synopsis about the Alert Program® that precedes the article (same magazine) by Marci Laurel about the parent perspective on the Alert Program®.

Williams, M.S. & Shellenberger, S. (2002, May/June). Take Five! Staying alert at home and school. Autism-Asperger’s Digest Magazine, 24-26. Comment: This three-page article provides sample information about the Take Five! publication in a manner accessible to all readers.




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Winkle, M. (2008, June 30). Using AAT in corrections and residential facilities. OT Practice, 20-22. Comment: Describes the use of animal assisted therapy (AAT) in corrections facilities, residential treatment centers and reintegration centers. The author further describes how the Alert Program® is adapted to assist student trainees learn about themselves as well as their dog.

Zeidler, S. (2012, June 4). Sensory processing challenges in the schools: Learning “high,” “low,” and “just right” speeds. OT Practice, 14-19.

Comment: This article describes the implementation of a 6-week evidence-based self-regulation program at a suburban New York public elementary school. The study explored whether the Alert Program® was an effective school-based intervention for improving attention to task in seven students (ages 7-10) with self-regulation/attention difficulties. Results demonstrated a positive impact on the students’ ability to stay focused in the classroom, increased the number and variety of sensory-based strategies used by students, and changed how teachers viewed the effectiveness of sensory-based strategies for improving students’ attention to task.

C. Books/Manuscripts/Professional Texts

Frick, S., Frick, R., Oetter, P. & Richter, E. (1996). Discovering the developmental significance of the mouth: “Out of the mouth of babes”. (p. 22). Stillwater, MN: PDP Press, Inc. Comment: An extremely useful book that provides an overview of the therapeutic significance of the mouth for facilitating normal development, including self-regulation. The Alert Program® is introduced (page 22) as a resource for helping learn self-regulation.

Kramer, J.G. (1999). Sensory integration frame of reference: Theoretical base, function/dysfunction continua, and guide to evaluation. In Frames of reference for pediatric occupational therapy, 2nd ed. (pp. 119-204). Philadelphia, PA: Lippincott. Comment: Provides a good overview of the Theory of Sensory Integration. Includes discussion of the use of the Alert Program® for children with sensory system modulation issues (p. 185).

Mauro, T. (2006). The everything: Parent’s guide to sensory integration disorder (pp. 279-280). Avon, MA: F+W Publications, Inc. Comment: This book contains information about the Alert Program® (chapter 24): Helping Children Manage Their Sensory Needs.

Muhlenhaupt, M. (2008). School-based practice: Enabling participation. In Crepeau, E.B., Cohn, W.S. & Boyt Schell, B.A., Willard and Spackman’s occupational therapy, 11th ed. (pp. 890-895). Philadelphia: Lippincott Williams & Williams. Comment: Using a case study (pp 894-895), the author demonstrates the use of the Alert Program® with a child in the school system.

Northern Territory Government Australia (2001). Learning through the senses resource manual: The impact of sensory processing in the classroom. Department of Health and Community Services: Northern Territory Government Australia. Comment: Discusses the use of the Alert Program® superimposed onto another intervention model (pp. 16-21).

Oetter, P., Richter, E.W., & Frick, S.M. (1988). M.O.R.E. Integrating the mouth with sensory and postural functions. Hugo, MN: PDP Press, Inc. Comment: This publication, based on the Theory of Sensory Integration, provides strong theoretical background, developmental issues, and strategies related to the suck, swallow, and breathe synchrony. The Alert Program® is introduced in the context of self-regulation (p. 27).

Parham, D. & Mailloux, Z. (2005). Sensory integration. In Case-Smith, J., Occupational therapy for children, 5th ed. (pp. 356-409). St. Louis, MO: Mosby. Comment: Use of the Alert Program® is discussed in the assessment and consultation section (page 395).




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Rotz, R. & Wright, S.D. (2005). Fidget to focus--Outwit your boredom: sensory strategies for living with ADD. Lincoln, NE: iUniverse. Comment: The authors (clinical psychologists) share their experiences with children with ADD and sensory processing deficits. Authors advocate for occupational therapy and the Alert Program® (pp. 21-23).

Schneider, C.C. (2001). Sensory Secrets: How to jump-start learning in children. Siloam Springs, AR: Concerned Communications. Comment: This publication addresses sensory processing deficits related to learning. A description of the Alert Program® and its value for children (p. 116) is provided.

Schwab, D. (1999). Reframing Perceptions: How Children with FAS/E Sense the World. In Mayer, L. (Ed.) Living and working with fetal alcohol syndrome/effects. Winnipeg: Interagency FAS/E Program. Comment: Chapter describing sensory integration as it relates to individuals with fetal alcohol syndrome. Also introduces the Alert Program® as a valuable tool for use by individuals with fetal alcohol syndrome (pp. 79-82; 97-100).

Just Added Shanker, S. (2013). Calm, alert, and learning: Classroom strategies for self-regulation. (pp. 16-20). Don Mills, Ontario: Pearson Canada, Inc.

Comment: Grounded in original work of Stanley Greenspan, the author acknowledges the importance of self-

regulation to a student’s ability to succeed in the classroom. The development of self-regulation and its importance in providing the foundation for higher metacognitive functions is presented. The primary focus of this text is a look at self-regulation through an exploration of five domains as well as six critical elements to optimal self-regulation that can be applied in the classroom. The Alert Program® is described and demonstrated in relation to the most fundamental of domains—biological self-regulation. This text is an excellent resource for teachers and therapists alike.

Shellenberger, S. & Williams, M.S. (2002). “How does your engine run?”™: The Alert Program® for self-regulation. In A.G. Fisher, E.A. Murray, & A.C. Bundy (Eds.) Sensory integration: Theory and practice (pp. 342-345). Philadelphia, PA: F.A. Davis. Comment: Within a text on the Theory of Sensory Integration, the authors present the Alert Program® in Chapter 14: Alternative and Complementary Programs for Intervention.

Smith-Roley, S. & Jacobs, S.E. (2008). Sensory integration. In Crepeau, E.B., Cohn, W.S. & Boyt-Schell, B.A., Willard and Spackman’s occupational therapy, 11th ed. (pp.792-817). Philadelphia: Lippincott Williams & Williams. Comment: The Alert Program® is listed as a complementary approach to traditional sensory integration methods (p. 805).

D. Un-published Graduate Theses/Dissertations Just Added Abela, S. (2013). The outcomes of the Alert Program® in a school setting and the

perspectives of those involved. Unpublished honours thesis, University of Malta. Msida, MSD. (contact: [email protected])

Comment: This thesis describes a qualitative approach to evaluating outcomes of the use of the Alert Program® in eight (8) 4th grade students (4 with ADHD and 4 with typical behavior). Additionally, perceptions of participating teachers, parents and students were documented. Results reported improvement in all 8 children’s ability to work independently and follow instructions. Additionally, there was a reported major change in parent and teachers’ perceptions and interpretations of behaviors that were otherwise thought to be distracting as well as an awareness of strategies to support children’s attempts to self-regulate. Both parents and teachers expressed the need for more training and support in this area.

Boblitt, K. (2007). Effectiveness of a teacher in-service for introducing sensory strategies in the general education classroom. Unpublished master’s thesis, San Jose State University. San Jose, California. (contact: [email protected])

Comment: Study evaluates the effectiveness of a 2 hour Alert Program® (AP) in-service on teacher’s perception of AP interventions. Results suggested that teachers began to interpret children’s behaviors related to inattention differently. Teachers perceived AP sensory strategies used to support self-regulation as being “effective”.




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Bowen, M., Cloutier, A., & Nichols, A. (2011). The lived experience of OT practitioners using the Alert Program® with children with autism spectrum disorder. Unpublished master’s thesis, University of Southern Maine. Gorham, Maine.

(Contact: [email protected])

Comment: This qualitative research utilized a phenomenological approach with six occupational therapy practitioners to explore their perceptions of implementing the Alert Program® with a population of children diagnosed on the autism spectrum. Three significant themes emerged: 1) the importance of ownership and self-advocacy that the Alert Program® brings to both the children and adults involved; 2) the ease of use and carryover across environments; and 3) the value of the tool to therapists in providing a language that makes sense and the ability to adapt the tool to meet individual needs.

Chiodo, P.G. (2010). Outcomes on attention with an implementation of the Alert Program® in a school-based setting. Unpublished Evidence-Based Occupational Therapy Scholars Capstone, Chatham University. Pittsburgh, PA. (contact: [email protected])

Comment: A program evaluation was completed on the implementation of the Alert Program® in self-contained language learning disability classrooms (first through third grades). Both quantitative and qualitative outcomes demonstrated an increase in the students’ (sample size of 8) attention to task and a decrease in the amount of redirection required during activities. Additionally, results demonstrated an improved ability of the teachers to recognize the impact of sensory interventions on attention.

Clark, M.N., Pritchett, M.D., & Vandiver, A. L. (2011). The effects of the Alert Program® on communication and interaction skills of adults with severe and persistent mental illness in a community mental health setting. Unpublished master’s thesis, Brenau University, Gainesville, Georgia. (contact: [email protected])

Comment: This study investigated the effects of the Alert Program® on communication and interaction skills of adults with severe and persistent mental illness. The sample of 8 adults was obtained from a community mental health setting. Findings of the study were found to be statistically significant with increased communication and interaction skills documented. Analysis of results indicated that the Alert Program® was the main contributing factor for increased scores. This has significant implications for OT in that it provides evidence that provision of sensory regulation techniques can help persons with mental illness to better attend and participate.

Just Added Link, C.C., Parkman, C.D., & Frame, H.R. (2012). The effects of the Alert Program® on the communication and interaction skills of adults with developmental disabilities (DD) who display atypical sensory processing during group activities. Unpublished master’s thesis, Brenau University. Gainesville, Georgia. (contact: thesis advisor [email protected])

Comment: This study used a single-subject semi-parametric ratio estimator (SPRE) design and involved 14 subjects with developmental disabilities who displayed atypical sensory processing abilities and resided in a community-based facility. Results supported the hypothesis that the use of the Alert Program® would increase or stabilize communication and interactions skills of this population during group activities.

Maddaleni, A.L. (2005). The effects of the Alert Program® on attention and participation of children in inclusion classrooms. Unpublished master’s thesis, University of New Mexico. Albuquerque, New Mexico. (contact: [email protected]) Comment: Study examines the effect of the Alert Program® on attention and participation of children, with self-regulation difficulties, in an inclusion classroom. Results suggest that the Alert Program® provides some benefits to children with arousal and attention difficulties.

Oliver, J., Martin, L, Davis, G. & Scheerer, C. (2005). Use of sensory-based techniques for increasing time on task in adults with mental retardation. Unpublished thesis, Xavier University, Cincinnati, Ohio. Comment: Study analyzes sensory strategies (adaptation of Alert Program®) for increasing time on task and work production in adults with mental retardation. Three case studies presented; increase in time on task and work production noted but not significantly.




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Prescott, S.L. (2002). Measuring change in paediatric occupational therapy: The Alert Program®. Unpublished BSc. Thesis, Queen Margaret University College, Edinburgh, Scotland. (contact: [email protected]) Comment: Study incorporated mixed methodology, using the Model of Human Occupation as a framework to evaluate the effectiveness of the Alert Program®. Results indicated improvement in several occupational performance areas, particularly at home.

Quine-Smith, M. (2002). Occupational therapy and literacy. Unpublished master’s thesis, University of New Mexico, Albuquerque, New Mexico. (contact:[email protected]) Comment: Research focused on the role of school-based OT in literacy programs. A significant result of surveying OT’s reflected that the Alert Program® was one of the two most widely used tools in school-based practice.

Verno, B.E. (2008) The effectiveness of the Alert Program® in the public schools as reported by occupational therapists. Unpublished master’s thesis, James Madison University. Harrisonburg, Virginia. (contact: [email protected]) Comment: This study evaluated the effectiveness of the Alert Program® as perceived by occupational therapists. 96.6% of respondents reported that use of the AP improves students' ability to maintain attention to task during class activities.

E. Popular Press McCrory, A. (2003, September 8). Teacher uses inflatable ball chairs to help pupils stay

focused on work. Pensacola News Journal. p. C9-8. Comment: This article describes how a teacher incorporated information from the two day Alert Program® lecture to support students in her classroom.

“How Does Your Engine Run?® for Self-Regulation. Families Online Magazine. Retrieved January 2008, from www.FamiliesOnlineMagazine.com/alert-program.html Comment: Families Online Magazine, which offers families help from parenting, health, and child development experts, provides an overview of the history and focus of the Alert Program®.

McIlroy, A. (2011, May 27). Rewiring the brains of children with fetal alcohol syndrome. Globe and Mail. Retrieved June 7, 2011, from http://www.theglobeandmail.com Comment: This is a newspaper article highlighting local research being done. The principles of the Alert Program® are applied in three classrooms for children with FASD at David Livingstone public school in Winnipeg. The Canadian Institutes of Health Research and Canadian Foundation on Fetal Alcohol Research funded this 12-week program, directed by researchers from Toronto’s Hospital for Sick Children. Preliminary results are to be presented in September 2011.

Mauro, T. (2006). Book Review: “How Does Your Engine Run?” The Alert Program™ for self-regulation. About.com: Parenting Special Needs. Retrieved August 25, 2007, from www.SpecialChildren.About.com/od/sensoryintegration/gr/enginerun.htm Comment: Provides a review of TherapyWorks, Inc. publication titled An Introduction to “How Does Your Engine Run? ®” The Alert Program® for Self-Regulation (booklet).

Morris, M. Sensory diet vs. The Alert Program™ (“How Does Your Engine Run”): What’s the difference and how can they help my child? Retrieved July 3, 2008 from www.Sensory-Processing-Disorder.com/how-does-your-engine-run.html Comment: From a parent’s perspective, the author discusses the difference between a sensory diet (created by others) and the Alert Program® (teaching self-regulation)

Murphy, A.P. & Schultz, K. Kids’ nasty habits are good. Nasty Habits: A Blessing in Disguise? Retrieved February 8, 2002, from http://abcnews.go.com/GMA/AmericanFamily/story?id=126358&page=1 Comment: (Emphasis on “GENERAL” sensorimotor strategies). A lay-person’s introduction regarding children’s use of sensory strategies (hair twirling, sucking thumb, etc.) to a child’s ability to attend and self-regulate. The Alert Program® is specifically mentioned in this article.



SECTION II: Articles on the Effectiveness of Sensorimotor Strategies that Support Self-Regulation, Learning and Living

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SECTION II Articles on the Effectiveness of Sensorimotor Strategies

that Support Self-Regulation, Learning and Living

The following articles are organized alphabetically with notes in the comment sections that correlate to the Alert Program®’s five ways to change alert levels: Mouth, Move, Touch, Look, and Listen.

A. Refereed Professional Journals Abicoff, H. & Courtney, M.E. (1996). The effects of auditory stimulation on the

arithmetic performance of children with ADHD and nondisabled children. Journal of Learning Disabilities, 29:3, 238-250. Comment: (Emphasis on “Listen” strategies). This study examined the impact of using either music, speech or silence on arithmetic tasks by children diagnosed with ADHD and non-disabled children. Results indicate a significant increase in number of arithmetic problems attempted and in the number of correct answers for children with ADHD. This provides support for the prevalence of self-regulation issues (under-arousal/optimal stimulation theory) of ADHD.

Bagatel, N., Mirigliani, G., Patterson, C., Reyes, Y., Test, L., (2010). Effectiveness of therapy ball chairs on classroom participation in children with autism spectrum disorders. American Journal of Occupational Therapy, 64, 895-903.

Comment: (Emphasis on “Move” strategies). This single-subject design research examined the effectiveness of therapy ball chairs on classroom participation in 6 boys with autism spectrum disorder. The ball chair had the most significant impact on those boys who had the most vestibular-proprioceptive-seeking behaviors. Those children who demonstrated postural difficulties demonstrated least improvement in participatory behaviors. This research reinforces the need for skilled clinical reasoning and individualizing strategies for each child’s unique needs.

Barros, R.M., Silver, E., & Stein, R.E. (2009). School recess and group classroom behavior. Pediatrics, 123:2, 431-436. Comment: (Emphasis on “Move” strategies). Teacher’s rating of classroom behavior was better for 8- to 9-year old children who experienced recess than those with none/minimal. These findings support importance of recess for learning and attention.

Brown, R.P., Gerbarg, P.L. (2005). Breathing in the treatment of stress, anxiety, and depression: Part I---Neurophysiologic model. Journal of Alternative and Complementary Medicine, 11(1), 189-201. Comment: (Emphasis on “Mouth”/breathing strategies). A model that focuses on yogic breathing as a unique method for balancing the autonomic nervous system and influencing psychological and stress-related disorders is presented. Neurological mechanisms contributing to the state of calm alertness are described.

Brown, R.P., Gerbarg, P.L. (2005). Sudarshan Kriya yogic breathing in the treatment of stress, anxiety, and depression: Part II--- Clinical applications and guidelines. Journal of Alternative and Complementary Medicine, 11(4), 711-717. Comment: (Emphasis on “Mouth”/breathing strategies). This study provides evidence to consider Sudarshan Kriya Yoga breathing as a potentially low-risk adjunct treatment. The power of yoga techniques in enhancing well-being, mood, attention, mental focus and stress tolerance is presented. The feasibility of integrating yoga breath techniques into school curricula is explored.




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Bryan, L.C. & Gast, D.L. (2000). Teaching on-task and on-schedule behaviors to

high-functioning children with autism via picture activity schedules. Journal of Autism and Developmental Disorders, 30:6, 553-567.

Comment: (Emphasis on “Look” strategies). This study emerges from the discipline of education and

focuses on the use of visual prompting strategies to increase on-task and on-schedule behaviors for students with high-functioning autism. Results supported the use of graduated guidance procedure and picture-activity schedule teaching strategies in teaching students with autism to engage in on-task and on-schedule behaviors. All of the four students involved in this study became more independent using the picture schedules and relied less upon adult prompting during literacy-based activities.

Cannella-Malone, H.I., Tullis, C.A., & Kazee, A.R. (2011). Using antecedent exercise to decrease challenging behavior in boys with developmental disabilities and an emotional disorder. Journal of Positive Behavior Interventions, 13:4. 230-239.

Comment: (Emphasis on “Move” strategies). This study evaluated the effectiveness of providing systematic exercise eight times per day in reducing challenging behaviors in a school environment. Results of the study demonstrate success of exercise in decreasing the frequency of challenging behavior to zero or near-zero levels in three students with moderate to severe developmental disabilities and an emotional disorder. Challenging behaviors decreased to zero for two participants and near zero for the third participant. Types of exercises are clearly described. Intrinsic motivation of students was noted. It also demonstrated how teaching staff is able to successfully implement and document the program across the entire day and across all school environments.

Cheng, M., Boggett-Carsjens, J. (2005). Consider sensory processing disorders in the explosive child: Case report and review. Canadian Child and Adolescent Psychiatry Review, 14(2), 44-48. Comment: (Emphasis on “General Strategies”). Anecdotal evidence is presented suggesting that sensory processing disorders may potentially play a large role in children and youth demonstrating affect regulation problems (e.g. bipolar disorder, oppositional defiant disorder). This article presents a case report where diagnosis and management includes the development of a sensory diet. While not mentioned specifically, the Alert Program® provides a structured program to assist professionals in developing such a sensory diet and enhancing self-knowledge with this population. A narrative review of the literature is also provided.

Davis, C.L., Tomporowski, P.D., Boyle, C.A., Walter, J.L., Miller, P.H., Naglieri, J.A., & Gregoski, M. (2007). Effects of aerobic exercise on overweight children’s cognitive functioning. Research Quarterly for Exercise and Sport, 78:5, 510-519.

Comment: (Emphasis on “Move” strategies). The study tests the effect of aerobic exercise on executive function in overweight children. Ninety-four overweight children ranging from 7-11 years of age were randomly assigned to three groups: 1) low-dose exercise; 2) high-dose exercise; or 3) no-exercise control group. The high-dose group demonstrated significantly greater on executive function processes (strategy generation & application, self-regulation, intentionality, & utilization of knowledge). This study provides additional evidence in support of the important role of the Alert Program®’s use of sensory-motor strategies for organizing higher level cognitive functioning.

Edelson, S.M., Edelson, M.G., Kerr, D.C.R., & Grandin, T. (1999). Behavioral and physiological effects of deep pressure on children with autism: A pilot study evaluating the efficacy of Grandin’s hug machine. American Journal of Occupational Therapy, 53(2), 145-152.

Comment: (Emphasis on “Touch/Deep Pressure” strategies). This pilot study investigates the effects

of deep pressure, using Grandin’s Hug Machine, on children with autism. Twelve children with autism were randomly divided between two groups: those who received the Hug Machine twice a week for 6 weeks (experimental group), and those who did not (placebo group). Behavioral and physiological indicators of arousal were measured before and after deep pressure was provided. Results support previous reports that deep pressure appears beneficial for children with high levels of anxiety or arousal. Authors suggest that there may be a threshold of anxiety or arousal required for deep pressure to be beneficial.




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Escalona, A., Field, T., Singer-Strunck, R., Cullen, C., & Harshorn, K. (2001). Brief report: Improvements in the behavior of children with autism following massage therapy. Journal of Autism and Developmental Disorders, 31:5, 513-516.

Comment: (Emphasis on “Touch” strategies). Twenty children (ages 3 to 6 years) were randomly assigned to massage and reading attention control groups. The massage group received 15 minutes of parent provided massage prior to bedtime every night for one month. The study results demonstrate significant improvements in off-task behavior and sleep problems, and children were noted to be more attentive at school. Stereotypical behaviors also decreased in the classroom and on the playground.

Evenson, K.R., Ballard, K., Lee, G., Ammerman, A. (2009). Implementation of a school-based state policy to increase physical activity. School Health. 79, 231-238.

Comment: (Emphasis on “Move” strategies). This article describes the outcome of the 2005 North Carolina State Board of Education policy to include a requirement for physical activity for kindergarten through eighth-grade students throughout the state. An on-line survey was conducted to explore how districts were meeting the physical activity-related portion of the policy and also to explore the implementation successes and challenges. Results indicated many positive results for both students and staff. Benefits identified were numerous with greater student focus and student alertness included.

Fedewa, A., Erwin, H. (2011). Stability balls and students with attention and hyperactivity concerns: Implications for on-task and in-seat behavior. American Journal of Occupational Therapy, 65, 393-9.

Comment: (Emphasis on “Move” strategies). Using a single-subject A-B research design, researchers evaluated the effects of stability balls on in-seat and on-task behavior of eight 4th & 5th grade students with attention and hyperactivity concerns. Results revealed increased levels of attention, decreased levels of hyperactivity, and increased time on task and in-seat/on ball time. This study provides additional evidence for the use of a movement strategy (via therapy ball) to support attention and learning.

Just Added Fenech, A. & Baker, M. (2008). Casual leisure and the sensory diet: A concept for improving quality of life in neuropalliative conditions. NeuroRehabilitation, 23, 369-376.

Comment: (Emphasis on “General” strategies). These authors report two cases of adult individuals with neuropalliative conditions which, due to the complexity of these types of disabilities, often lead to passive lifestyles and spectator roles. The two case studies presented illustrate the development of casual lifestyles based on sensory profiles and tailored around the sensory diet framework. Results demonstrate the successful use of the sensory diet as a guide through which to plan leisure routines leading to an enhanced quality of life.

Fertel-Daly, D., Bedell, G., Hinojsa, J. (2001). Effects of a weighted vest on attention to task and self-stimulatory behaviors in preschoolers with pervasive developmental disorders. American Journal of Occupational Therapy, 55, 829-840. Comment: (Emphasis on “Move” /proprioception/heavy work/ strategies). This study examined the effectiveness of using weighted vests with preschool children with pervasive developmental disorders on attention and fine motor tasks. Results suggest that vests helped increase attention to task and decrease in self-stimulatory behaviors.




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Foss-Feig, J.H., Tadin, D., Schauder, K.B., & Cascio, C.J. (2013). A substantial and unexpected enhancement of motion perception in autism. The Journal of Neuroscience, 33(19), 8243-8249.

Comment: (Emphasis on “Move” strategies). This study, including 20 children with autism and 26 typically developing children, aged 8-17, investigates perception of motion. Results show that people with autism have enhanced visual abilities with heightened perception of motion. This outcome suggests that brains of individuals with autism keep responding more and more as intensity increases which can lead to sensory overload. This study supports the need for ongoing critical reasoning and problem solving by the practitioner in providing movement strategies for individuals with autism. Behavioral observations help determine the just right movement modality supportive of attention and learning.

Gallotta, M.C., Guidette, L., Franciousi, E., Emerenziani, G.P., Bonavolonta, V., & Baldari, C. (2011). Effects of varying type of exertion on children’s attention capacity. [Epub ahead of print]. Medicine & Science in Sports & Exercise, August 1. Comment: (Emphasis on “Move” strategies). The purpose of this study is to examine the effects of varying types of exertion on immediate attentional performance on 138 regular primary school boys and girls. The three types of exertion: 1) physical exertion (primarily physical education/cardiovascular in nature); 2) cognitive exertion; and 3) cognitive and physical exertion.

Grandin, T. (1992). Calming effects of deep touch pressure in patients with autistic disorder, college students, and animals. Journal of Child and Adolescent Psychopharmacology, 2(1). Retrieved December 28, 1010, from http://grandin.com/inc/squeeze.html Comment: (Emphasis on deep pressure “Touch” strategies). Temple Grandin provides an overview of the clinical effects of deep touch pressure and provides a description of her deep touch pressure device (“squeeze machine”) that helped her overcome problems of oversensitivity to touch and that allays her nervousness. Additionally, she surveys animal literature on deep touch pressure, revealing similar calming reaction. She concludes with suggestions for clinical use with humans.

Hall, L., & Case-Smith, J. (2007). The effect of sound-based intervention on children with sensory processing disorders and visual-motor delays. American Journal of Occupational Therapy, 61, 209-215. Comment: (Emphasis on “Lisening” strategies). This study supports the use of therapeutic listening intervention coupled with a sensory diet to improve behaviors (including attention) of children related to sensory processing difficulties.

Hallam, S., Price, J., & Katsarou, G. (2002). The effects of background music on primary school pupils’ task performance. Educational Studies, 28(2), 111-122.

Comment: (Emphasis on “Listen” strategies). This paper presents two studies that explore the effect of music on arithmetic and memory tasks of children aged 10-12. Findings suggest that the effects of music are mediated by arousal and mood versus affecting cognition directly. Practical applications are discussed for primary school and home.

Just Added Hillman, C.H., Pontifex, M.B., Castelli, D.M., Khan, N.A., Raine, L.B., Scudder, M.R., et al. (2014). Effects of the FITKids randomized controlled trial on executive control and brain function. Pediatrics, 134:4.

Comment: (Emphasis on “Move” strategies). This study, a randomized controlled trial, used behavioral and electrophysiological measures of brain function to demonstrate enhanced attentional inhibition and cognitive flexibility for improved childhood cognition and brain health. Two hundred twenty-one children (7-9 years of age) were randomly assigned to a 9-month afterschool physical activity program. Outcomes support the importance of physical activity for optimal executive function, including attention and alertness.




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Holmes, R., Pellegrini, A., & Schmidt, S. (2006). The effects of different recess timing regimens on preschoolers’ classroom attention. Early Child Development and Care, 176 (7), 735-743.

Comment: (Emphasis on “Move” strategies). This study explored the effects of different recess timing regimens on preschool students’ attention in the classroom. Findings reveal that post-recess attention was greater following sustained outdoor play with girls demonstrating greater attention than boys. This study supports the need for movement--- specifically recess--- for bolstering children’s sustained attention in the classroom.

Just Added Johnson, A.J., Muneem, M., & Miles, C. (2013). Chewing gum benefits sustained attention in the absence of task degradation. Nutritional Neuroscience, 16:4, 153-9.

Comment: (Emphasis on “Mouth” strategies). This study examines the effects of chewing gum on sustained attention. Self-rated measures of alertness, contentedness and calmness were taken before and after a task. Results support results of past studies on the effects of chewing gum on attention with evidence that chewing gum can facilitate sustained attention and elevate perceptions of alertness.

Kercood, S., Grskovic, J.A., Lee, D.L., & Emmert, S. (2007). The effects of fine motor movement and tactile stimulation on the math problem solving of students with attention problems. Journal of Behavioral Education, 16, 303-310.

Comment: (Emphasis on “Touch” strategies). This study, employing a single-subject alternating treatments design, evaluated the effectiveness of fine motor (fidget) activity on students’ ability to engage in math problem solving activities. Eight 4th & 5th grade students with attention problems participated. Results suggest that fine motor manipulation of a tactile stimulation object reduced excessive motor movement and increased task completion.

Kimball, J., Lynch, K., Stewart, K., Williams, N., Thomas, M., & Atwood, K. (2007). Using salivary cortisol to measure the effects of a Wilbarger protocol-based procedure on sympathetic arousal: A Pilot study. American Journal of Occupational Therapy, 61, 406-413. Comment: (Emphasis on “Touch”/deep pressure strategies). This study investigated changes in salivary cortisol (stress hormone) following administration of the Wilbarger protocol to children diagnosed with sensory defensiveness.

Leveille, G., McMahon, K., Alcatara, E., & Zibell, S. (2008). Benefits of chewing gum: Oral health and beyond. Nutrition Today, 43(March/April), 75-81. Comment: (Emphasis on “Mouth” strategies). Conclusions suggest that chewing gum may have a positive impact on cognitive function, specifically concentration and focus and weight management.

Lin, C-K, Min, Y-F, Chou, L-W, & Lin, C-K. (2012). Effectiveness of sensory processing strategies on activity level in inclusive preschool classrooms. Neuropsychiatric Disease and Treatment, 2012:8, 475-481.

Comment: (Emphasis on “General Strategies”). This study was conducted to measure whether sensory processing strategies could reduce excessive activity levels in children with sensory integration dysfunction. Thirty-six (36) subjects equally divided between the intervention and control groups and ranging in age from 36-72 months of age, were selected from kindergarten classrooms in three different towns of central Taiwan. Those children who ranked in the 73rd percentile or higher on the Test of Sensory Integration Function, who did not receive any sensory integration treatment during or before the study, and who could be matched to the intervention and control groups were included in the intervention group of the study. Although the treatment effect did not reach statistical significance, activity level improved in the intervention group. Results could not exclude a developmental effect over the 8-week session.




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Mahar, M., Murphy,s., Rowe, D., et al. (2006) Effects of a classroom-based program on physical activity and on-task behavior. Medical Science of Sports and Exercise, 38(12). 2086-2094. Comment: (Emphasis on “Move” strategies). This study evaluated the effects of a classroom-based physical activity program on children’s in-school physical activity levels and on-task behavior during academic instruction. Results indicated significant improvements in directly observed on-task behavior. This behavior was particularly strong among the least on-task students with an increase in on-task behavior of 20% after participation in 10 minutes of physical activity. This study provides support for use of the Alert Program® MOVE strategies in supporting appropriate arousal and attention levels.

Mullen, M., Champagne, T., Krishnamurty, S., Dickson, D., & Gao, R.X. (2008). Exploring the safety and therapeutic effects of deep pressure stimulation using a weighted blanket. Occupational Therapy in Mental Health, 24:1, 65-89.

Comment: (Emphasis on “Touch/Deep Pressure” strategies). This study provides the results of an

initial exploratory study on the safety and effectiveness of using a 30 lb weighted blanket with 32 non-acute, non-hospitalized adults. Quantitative and qualitative metrics were piloted to determine use in future studies with adults during an acute inpatient mental health hospitalization and a non-acute, volunteer adult population subjected to a high anxiety task. Results indicate that the use of the 30 lb blanket has a calming effect for some adults. Results also highlighted limitations and future considerations for ongoing research in this area.

Pellegrini, A.D., Davis, P. (1995). The effects of recess timing on children’s playground and classroom behaviors. American Educational Research Journal, 32, 845-864. Comment: (Emphasis on “Move” strategies). Results indicate that students are less attentive and work less efficiently when confined to classrooms in continuous instruction time. Findings support importance of recess (movement) for student attentiveness in the classroom.

Peck, H.L., Kehle, T.J., Bray, M.A., & Theodore, L.A. (2005). Yoga as an intervention for children with attention problems. School Psychology Review, 34(3), 415-424. Comment: (Emphasis on “General Strategies”). This study explored the effectiveness of yoga for improving time on task with 10 elementary school children with attentional problems. Activities implemented included physical postures, deep breathing and relaxation exercises. Results contribute to the existing literature on yoga’s role in improving children’s attention in school and suggest that yoga may become a promising alternative or complement to existing interventions for attentional difficulties.

Pfeiffer, B., Henry, A., Miller, S. & Witherell, S. (2008). The effectiveness of Disc ‘O’ Sit cushions on attention to task in second-grade students with attention difficulties. American Journal of Occupational Therapy, 62, 274-281. Comment: (Emphasis on “Move” strategies). This randomized controlled trial design study investigated the effectiveness of a dynamic seating system for improving attention to task in 63 second grade students. The results provide preliminary evidence for the use of the Disc ‘O’ Sit cushion as and occupational therapy intervention to improve attention in the school setting.

Pfeiffer, B. & Kinnealey, M. (2003). Treatment of sensory defensiveness in adults. Occupational Therapy International, 10(3), 175-184. Comment: (Emphasis on deep pressure “Touch & Move” strategies). This quasi-experimental pilot study demonstrates the effectiveness a self-treating lifestyle, including activities either daily or several times a week that provide proprioceptive, vestibular and/or tactile stimulation, on 15 adults who self-identified as having sensory defensiveness in one or more sensory systems. Results of the provide significant support for the relationship between anxiety, attentional difficulties and sensory defensiveness in adults with no psychiatric diagnoses.




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Rapport, M.D., Bolden, J., Kofler, M.J., Sarver, D.E., Raiker, J.S., Alderson, R.M. (2009). Hyperactivity in boys with attention-deficit/hyperactivity disorder (ADHD): A ubiquitous core symptom or manifestation of working memory deficits? Journal of Abnormal Child Psychology, 37, 521-534. Comment: (Emphasis on “Move” strategies). Study investigates whether children’s activity level is functionally related to working memory demands associated with executive functioning. Results support the use of movement to improve working memory and attention and suggest that behavioral programs to reduce movement may indeed be counterproductive to improving classroom performance.

Just Added Reynolds, S.J., Lane, S.J., & Mullen, B. (2015). Brief Report---Effects of deep pressure stimulation on physiological arousal. American Journal of Occupational Therapy, 69, 6903350010.

Comment: (Emphasis on “Move”/proprioception/heavy work strategies). This research focuses on the effects of deep pressure stimulation, applied through a Vayu Vest (Therapeutic Systems, Amherst, MA) on both performance and autonomic arousal in a normative adult sample of fifty individuals. Results support the use of deep pressure stimulation to change one’s physiological arousal. Results provide further evidence for the use of deep pressure with people who experience difficulty with arousal regulation and sensory modulation during or in preparation for functional tasks.

Scheerer, C.R. (1992). Perspectives on an oral motor activity: The use of rubber tubing as a “chewy.” American Journal of Occupational Therapy, 46(4), 344-352. Comment: (Emphasis on “Mouth” strategies). Three case studies are presented that demonstrate the therapeutic benefits of a “chewy” (rubber tubing). Use of chewy seemed to have a calming, organizing, and focusing effect on the child. The included literature review provides supporting benefits of oral motor input to support attention and learning.

Schilling, D.L., Washington, K., Billingsley, F.F., & Deitz, J. (2003). Classroom seating for children with attention deficit hyperactivity disorder: Therapy balls versus chairs. The American Journal of Occupational Therapy, 57(5), 534-541. Comment: (Emphasis on “Move” strategies). Study investigates the effects of therapy balls as classroom seating on a students in-seat behavior and legible word productivity. Results found that use of the therapy ball had potential to meet individual movement needs to help children achieve optimal state of arousal for attending and learning.

Schilling, D.L. & Schwartz, H.S. (2004). Alternative seating for children with autism spectrum disorder: Effects on classroom behavior. Journal of Autism and Developmental Disorders, 34, 423-431. Comment: (Emphasis on “Move” strategies). A single-study withdrawal design was used to measure the effects of using therapy balls as seating on engagement and in-seat behavior of 4 children with Autism Spectrum Disorder (ASD). Findings indicated substantial improvement in both in-seat behavior and engagement across all four participants. Additionally, teachers and students reported a preference for therapy balls, versus other seating options.

Silva, L.M.T., Schalock, M., Ayres, R., Bunse, C., & Budden S. (2009). Qigong massage treatment for sensory and self-regulation problems in young children with autism: A randomized controlled trial. American Journal of occupational Therapy, 63, 423-432.

Comment: (Emphasis on “Touch” strategies). Article presents the results of a randomized controlled study evaluating the effect of Qigong massage directed toward improving sensory integrative dysfunction in children with autism. Of significance, the use of massage intervention resulted in improved ability of the child to socially orient and to remain calm while making the many transitions required by family and preschool life. Results are encouraging in support of massage as an easily administered strategy for treating sensory and self-regulation problems in children with autism.




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Just Added Smith, A. (2010). Effects of chewing gum on cognitive function, mood and physiology in stressed and non-stressed volunteers. Nutritional Neuroscience, 13:1, 7-16.

Comment: (Emphasis on “Mouth” strategies). This study involves 133 volunteers. Alertness and stress were measured by cortisol levels. Volunteers carried out tasks measuring a range of cognitive functions, including memory, selective and sustained attention, psychomotor speed and accuracy. Results support that chewing gum is associated with greater levels of alertness and a more positive mood. Reaction times were quicker, selective and sustained attention improved and heart rate and cortisol levels were higher when chewing, confirming the alerting effect of chewing gum.

Smith, A.L., Hoza, B., Linnea, K., McQuade, J.D., Tomb, M., Vaughn, A.J., et al. (2011, August 25). Pilot physical activity intervention reduces severity of ADHD symptoms in young children. Journal of Attention Disorders. Retrieved November 28, 2011 from http://jad.sagepub.com/content/early/2011/08/25/1087054711417395 Comment: (Emphasis on “Move” strategies). This pilot study examined the effects of a before-school physical activity (movement) on behaviors of 17 children (grades K-3) diagnosed with ADHD. Pilot results suggest that sustained involvement in physical activity benefits motor, cognitive, social and behavioral functioning in young peoples exhibiting ADHD symptoms. Parents, teachers and program staff reported overall improvement with most participants (64%-71%). Article’s review of literature documents studies that support the use of physical activity on neurological functioning.

Just Added Stephens, R., Edelstyn, N. (2011). Do individual differences moderate the cognitive benefits of chewing gum? Psychology, 2:8, 834-840.

Comment: (Emphasis on “Mouth” strategies). This study investigates whether a person’s individual differences underlie the cognitive benefits of chewing gum. This research replicated the null cognitive effects observed in several recent chewing gum experiments. However, this study helped identify individual differences where chewing gum is more likely to produce cognitive benefits: where people feel thirsty, in introverts, and where mental performance is sub-optimal. Cognitive benefits with chewing gum may occur through alleviation of stress and of thirst.

Stratton, J., & Gailfus, D. (1998). A new approach to substance abuse treatment. Adolescents and adults with ADHD. Journal of Substance Abuse Treatment, 15(2), 89-94. Comment: (Emphasis on “General Strategies”). This author present issues of arousal often seen in adolescents and adults with substance abuse issues. Sensory-motor intervention strategies focusing on self-regulation/arousal result in patients feeling a sense of increased independence and responsibility for themselves. Following treatment, staff report that patients demonstrate improvement in anger control, reduced impulsivity, marked relaxation and reduced hyper-arousal and increased attention span during group activities. All patients who followed their sensory-motor intervention plans were able to successfully complete the chemical dependency treatment where previous behavioral issues prevented such.

Tucha, D., Mecklinger, L., Maier, K., Hammerl, M., Lange, KW. (2004). Chewing gum selectively improves memory in healthy volunteers.” Appetite, 38 (3), 235-236. Comment: (Emphasis on “Mouth” strategies). A 58-person study found a significant positive effect of chewing gum on sustained attention, but not on improvement on participants’ memory function.

VandenBerg, N.L. (2001). The use of a weighted vest to increase on-task behavior in children with attention difficulties. American Journal of Occupational Therapy. 55, 621-628. Comment: (Emphasis on “Move” strategies). This study investigates the use of weighted vests on students’ on-task classroom behavior. Results support the use of deep pressure via a weighted vest to increase on-task behavior for children with attentional difficulties.




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Wahlstrom, K. (2002). Changing times: Findings from the first longitudinal study of later high school start times. NASSP Bulletin. 86:633, 3-21.

Comment: (Emphasis on “General Strategies”). Sleep is essential for the maintenance of all biological systems, including biochemical. Sleep helps balance the biochemistry of the body. This study provides evidence to link sleep patterns of adolescents to alertness, mood, peer-relationships and general academic and life competencies. The presented evidence encourages the practitioner to examine sleep patterns when working with adolescents who present with self-regulation difficulties. Addressing sleep routines may be a critical strategy for helping to organize the biochemistry of alertness.

White, B.P. & Mulligan, S.E. (2009). Application of psychobiological measures in occupational science and occupational therapy research. Occupational Therapy Journal of Research, 29: 4, 163-174. Comment: (Emphasis on “General” research strategies). This study provides an overview of physiological measures or biomarkers that are beginning to be used by occupational therapy researchers in measuring the complexity and effects of stress, self-regulation and arousal systems on occupational performance. This article provides valuable information to support practitioners in understanding the occupational relevance of these physiological measures and thereby enhancing the ability to share this emerging body of research-based evidence with an interdisciplinary audience.

Wilkinson, L., Scholey, A., Wesnes, K. (2002). Chewing gum selectively improves aspects of memory in healthy volunteers. Appetite, 38, 235-236. Comment: (Emphasis on “Mouth” strategies). A 75-person study showed that chewing gum appeared to improve people’s ability to learn, retain and retrieve information.

Wilmes, B., Harrington, L., Kohler-Evans, P., & Sumpter, D. (2008). Coming to our senses: Incorporating brain research findings into classroom education. The Education Digest, 128, 659-666. Comment: (Emphasis on “Look”, “Listen” and olfaction strategies). This is an educator focused article on sensory-filled strategies based on brain research. Classroom strategies for teachers is provided with research summaries (no citations or references provided).

B. Professional Newsletter/Magazines Just Added Carley, K. (2013 March). Sound therapy: A complementary intervention for

individuals with sensory integration and processing disorders, Part I. Sensory Integration Special Interest Section Quarterly, 36:1, 1-4.

Comment: (Emphasis on “Listen” strategies). This article, the first of a two-part series, presents the history as well as the neurological and theoretical foundations of sound therapy. The properties of sound therapy are described which helps guide a practitioner in integrating sound therapy programs into a sensory integration approach to intervention.

DeCleene, K. E. & Hayden-Sewall, A. A. (2007, December). Sound Therapy: How did it evolve and what is occupational therapy’s role? School System Special Interest Section Quarterly, 14(4), 2. Comment: (Emphasis on “Listen” strategies). Historical descriptions and summaries of sound therapy methods. It mentions self-regulation as a positive outcome of Therapeutic Listening™.

Just Added Goldstein, K., Huang, S., & Tu, K. (June, 2013). Sensory modulation therapy quality assurance study. Behavioral Health (Kings County Hospital Center/Behavioral Health Services), 4:12, 1-2.

Comment: (Emphasis on “General” sensory strategies). Three occupational therapy students observed and conducted their own sensory modulation groups in an in-patient behavioral health unit. In this newsletter article, they described their program as well as the quality assurance study that they also implemented. Results of the study reflected that the belief in the efficacy of Sensory modulation therapy as an effective treatment tool was unanimously positive.




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Harper, J., Warner, A.L. (2010, January 4). Researching combined interventions: Effectively addressing attention and auditory processing in school-age children. Advance OT Magazine, pp. 27-28. Comment: (Emphasis on “Listen” strategies). Preliminary electrophysiological findings of this study show a combination of sensorimotor therapy and sound intervention to be effective in treating children with auditory processing disorder and attention disorders.

Hoffman, S. (2011, January 31). Benefits of weighted products for managing sensory processing disorder. Advance OT Magazine, pp. 10-11. Comment: (Emphasis on deep/pressure “Move” strategies). A COTA describes her experience using deep pressure from weighted products to benefit individuals with autism or a sensory processing disorder. The article provides case stories demonstrating effectiveness as well as providing protocols for implementation, precautions and contra-indications.

Just Added May-Benson, T.A., Carley, K., Szklut, S., & Schoen, S. (2013 June). Sound therapy: A complementary intervention for individuals with sensory integration and processing disorders, Part II. Sensory Integration Special Interest Section Quarterly, 36:2, 1-4.

Comment: (Emphasis on “Listen” strategies). This article is the second of a two-part series focusing on sound therapy programs and how to apply these programs in occupational therapy practice. This article describes the most commonly used sound therapy programs, describes the pediatric populations that may benefit from such programs, examines the outcome effectiveness of cited programs, and finally, provides a case example.

Rice, M. Bulk up the brain. Retrieved August 16, 2011, from Advance for Physical Therapy and Rehab Medicine website: http://physical-therapy.advanceweb.com/ article/bulk-up-the-brain.aspx

Comment: (Emphasis on “Move” strategies). This physical therapist (author) discusses the benefits of physical movement with regard to school performance. The role of physical and occupational therapists in consulting with teachers on how to bring movement into the classroom is discussed.

Schriber Orloff, S.N. (2010, December 6). Doodling: A boost to the brain. Advance

OT Magazine, p. 9. Comment: (Emphasis on “Touch” & “Move” strategies). This author is a teacher who later became an O.T. She addresses the importance of doodling in the support of attention. The article cites research supportive of doodling to increase attention in the classroom and helping children learn.

Spinabella, K. (2011, August 1). Stand up for good health. Advance OT Magazine, p. 14.

Comment: (Emphasis on “Move” strategies). Use of the standing desk in both regular education and special education is discussed. Multiple benefits include: 1) improved attention, focus and task completion; 2) comfort and ergonomically correct positioning; 3) calorie consumption and general promotion of health. Multiple studies are cited supporting benefits.

C. Books/Manuscripts/Professional Texts Trott, M.C. (2002). Oh behave! Sensory processing and behavioral strategies.

Philadelphia: Therapy Skill Builders. Comment: This publication reflects an extremely practical blend of behavioral and sensory approaches to address day-to-day functioning, including self-regulation.




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D. Unpublished Graduate Theses/Dissertations Voytecki, K.S. (2005). The effects of hand fidgets on the on-task behaviors of a

middle school student with disabilities in an inclusive academic settings. Unpublished doctoral dissertation, University of South Florida. Comment: (Emphasis on “TOUCH” strategies). This single subject A-B-A-B design reports significant (40%) improvement in on-task behaviors and suggest, due to this preliminary study, that fidgets have promising implications for use with this population.

E. Popular Press Antoniades, C.B. (2010, March). The upside of fidgeting. Parenting school years. pp.

126-127. Comment: (Emphasis on “Touch” strategies). Author describes study by Mark Rapport, PhD related to fidgeting as a support for under-aroused brain function and working memory. Author encourages parents to talk with teachers about acceptable levels of movement to support their children’s learning.

Bernhardt, D. (March, 24, 2008). School on the run: Project combines workouts with

study. The StarPhoenix. Retrieved July 17, 2013, from http://johnratey.typepad.com/blog/2008/03/school-on-the-r.html

Comment: (Emphasis on “Move” strategies). Canadian Teacher Allison Cameron integrates treadmills, stationary bicycles, and weightlifting into Grade 8 class instructions for special needs students. She found 20 minutes of exercise translated into 2 hours of sustained concentration from students. Disciplinary problems decreased (67%) and use of medications plummeted. Importantly, attendance and academic performance improved.

Brownlee, S. & Watson, T. (1997, January 13). The senses. U.S. News & World Report. 51-59. Comment: (Emphasis on “General” sensorimotor strategies). In this popular press overview of the senses, authors discuss the importance of nurturing natural and uniquely individual sensory-motor capabilities and the effect of this nurturing on an individual’s health, emotions, even intelligence. Results of research on individual sensory systems can enhance the practitioners understanding of self-regulation.

Cloud, J. (2009, April 13). Better learning through fidgeting. Time Magazine. 61. Comment: (Emphasis on “Touch” strategies). Describes a recent study from University of Central Florida (UCF) that suggests that it is better to let children jiggle and fidget to facilitate learning. Suggests that children use movement the way adults use caffeine to stay focused.

CTV.ca News Staff (2006). Halifax school uses stability balls to calm kids. CTV News. Retrieved January 17, 2013, from http://www.henryot.com/pdf/Halifax%

20school%20uses%20stability%20balls%20to%20calm%20kids.pdf Comment: (Emphasis on “Move” strategies). This news article describes a 4th grade teacher’s solution

to fidgety, distracted and inattentive students. Replacing plastic desk chairs for therapy balls has been successful in increasing attention & concentration, improving posture, and helping burn calories. The school plans to purchase more balls to expand the experiment.

Morten, N. (2010, October 7) Stand-up desks in college station school fighting obesity. Retrieved August 16, 2011, from KBTX (CBS affiliate) television station website: http://www.kbtx.com/news/headlines/104533704.html

Comment: (Emphasis on “Move” strategies). This local College Station, Texas television station highlights a research project that focused on the benefit of using adjustable height stand-up desks in the classroom. The leading researcher, from Texas A&M Health Science Center School of Rural Public Health, found that students who used stand-up desks are not only burning calories, but also improving stamina while building a stronger attention span.




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Parker-Pope, T. (2009, February 24). The 3 R’s? A fourth is crucial, too: Recess. The New York Times Comment: (Emphasis on “Move” strategies). Discussion regarding recent research by Dr. Romina Barros suggesting that play (including recess) can influence behavior, concentration and even grades.

Soussan, T. (2009, August 2). Young and restless: Fidget toys, other distractions can help some children pay better attention in class. Albuquerque Journal, (Special Back to School Section) pp. 9, 12. Comment: (Emphasis on “Touch” strategies). Interviews with Albuquerque area therapists about using fidget toys to support attention.

Veenendall, J. (2008). Arnie and his school tools: Simple sensory solutions that build success. Shawnee Mission, KS: Autism Asperger Publishing Company. Comment: (Emphasis on “General” sensorimotor strategies). A children’s storybook about Arnie and strategies he uses to help him focus and attend.



SECTION III: Select Articles on the Relationship of Self-Regulation to Learning

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SECTION III:

Select Articles on the Relationship of Self-Regulation to Learning

Ashburner, J., Ziviani, J., & Rodger, S. (2008). Sensory processing and classroom emotional, behavioral and educational outcomes in children with autism spectrum disorder. American Journal of Occupational Therapy, 62, 564-573.

Comment: Academic success of children with ASD is often affected by their difficulty in self-regulation and resultant maladaptive emotional and behavioral responses. This study explored the associations between sensory processing and classroom emotional, behavioral and educational outcomes in children with autism spectrum disorder. High levels of tactile sensitivity were associated with attention difficulties, including inattentive and hyperactive behaviors. Reduced auditory filtering was associated with poor attention to cognitive tasks suggesting difficulty focusing on verbal instructions in noisy environments.

Blair, C. & Diamond, A. (2008). Biological processes in prevention and intervention: The promotion of self-regulation as a means of preventing school failure. Development and Psychopathology, 20 (3), 899-911.

Comment: This paper examines the interrelationship between emotion and cognition and provides good evidence of the importance of self-regulation competency for successful learning and adaptation to school. A strength of the article is that it challenges the current focus of early childhood education on academic learning and emphasizes the importance of promoting emotional, attentional, and behavioral regulation in children as potentially more effective in promoting school success throughout the school years as well as throughout life. A weakness of the article is it’s emphasis on top-down approach and incomplete/dated neurobiological support.

Just Added Blair, C. & Razza, R.P. (2007). Relating effortful control, executive function, and false belief understanding to emerging math and literacy ability in kindergarten. Child Development, 78:2, 647-663.

Comment: This study examines the role of self-regulation in emerging academic ability. Literature is cited that supports the central role of self-regulation to understanding how children adapt to and learn in the school setting. The results, although providing evidence related to the correlation between self-regulation and early academic ability, do have limitations due to the method of measurement utilized. The authors encourage further examination of the self-regulation construct, but yet the encourage promotion of academic achievement by fostering self-regulation.

Just Added Boekaerts, M. & Corno, L. (2005). Self-Regulation in the classroom: A perspective on assessment and intervention. Applied Psychology: An International Review, 54(2), 199-231.

Comment: The authors, coming from the discipline and perspective of educational psychology, provide an overview of the concept of self-regulation and it’s relationship to learning. They stress that effective coping and self-management can be facilitated through intervention strategies that focus on the student’s volition. This is compatible with the Alert Program®. The authors continue to provide a historical overview of assessment of self-regulation, the pros and cons of such tools and how these tools have changed as the definition of self-regulation has evolved into a more complex construct. Interventions common to their discipline are analyzed and presented. The authors conclude that classroom education, using the top-down and bottom up approaches, in conjunction with volitional strategies, can ultimately support optimal performance.

McClelland, M.M., Acock, A.C., Piccinin, A., Rhea, S.A., & Stallings, M.C. (2012). Relations between preschool attention span-persistence and age 25 educational outcomes. Early Childhood Research Quarterly (in press).

Comment: This study explores relations between children’s attention span-persistence in preschool and later school achievement and college completion. Results support that age 4 attention span-persistence skills significantly predicts the odds of completing college by age 25. The extensive review of literature in this article provides an in-depth overview of the growing body of evidence documenting the importance of self-regulation for long-term achievement and educational attainment.



SECTION III: Select Articles on the Relationship of Self-Regulation to Learning

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Just Added Raver, C.C., Li-Grining, C., Bub, K.,Jones, S.M., Zhai, F., & Pressler, E. (2011). CSRP’s impact on low-income preschoolers’ preacademic skills: Self-regulation as a mediating mechanism. Child Development, 82:1, 362-378.

Comment: The Chicago School Readiness Project (CSRP) evaluated low-income children’s school readiness through the mediating mechanism of self-regulation. This multi component, cluster-randomized efficacy trial involved 35 Head Start-funded classrooms (602 children). Results support curriculums that target children’s self-regulation skills through classroom-based processes due to significant pre-academic benefits observed in the sample population. These findings lend support to claims made in previous studies related to the importance of social, emotional and behavioral experiences to young children’s early and long-term learning.



SECTION IV: Select Articles on the Theory of Sensory Integration

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SECTION IV:

Select Articles on the Theory of Sensory Integration

Just Added American Occupational Therapy Association (n.d.) Essay: The current status of sensory integration therapy. Retrieved August 7, 2012, from http://www.aota.org/Practice/Children-Youth/SI/Resources.aspx#sthash.gD37Xy8a.dpuf

Comment: Florence Clark, President of AOTA presents her perspectives on the role of Sensory Integration Therapy (SIT) as an intervention approach for occupational therapists. Despite the continuing challenges and criticisms (while unjustified), she provides rationale for her belief that SIT will continue to be supported as an important intervention treatment option.

American Occupational Therapy Association (n.d.). AOTA critically appraised topics and papers series: What is the neurophysiologic evidence that using a sensory-based approach in occupational therapy with children and adolescents will be effective? Retrieved October 2, 1010, from http://www.aota.org/Educate/Research/CATsandCAPs/SI.aspx Comment: As part of AOTA’s Evidence-Based Literature Review Project, this Critically Analyzed Topic (CAT) provides a synthesis of a group of related articles. This particular CAT focuses on neurophysiologic evidence on the effectiveness of using a sensory-based approach in OT with children and adolescents. The studies analyzed provide “direct and robust support of neuroplasticity in many brain regions and that sensory input is an important mediator for this plasticity. Ayres’s (1972) original premise that sensory motor activity provides a foundation of learning is supported.

American Occupational Therapy Association (n.d.). AOTA critically appraised topics and papers series: What is the evidence for the existence of different types of sensory processing/sensory integration problems in children and adolescents? Retrieved October 2, 1010, from http://www.aota.org/Educate/Research/CATsandCAPs/SI.aspx Comment: As part of AOTA’s Evidence-Based Literature Review Project, this Critically Analyzed Topic (CAT) provides a synthesis of a group of related articles. This particular CAT focuses on the evidence of different types of sensory processing/sensory integration problems in children and adolescents. Articles included in this synthesis were divided by type of disability: autism/Asperger’s disorder; attention-deficit/hyperactivity disorder; developmental coordination disorder; learning disorders; and other disorders (such as Fragile X Syndrome). Few studies have directly tested whether children and adolescents with sensory integration dysfunction/sensory processing disorders can be classified into subtypes. However, the research provides some support to suggest that subtypes exist and treatment strategies may need to vary depending upon the type. Research also highlights the importance of a complete assessment of sensory processing abilities due to variations of abilities with different diagnoses.

Franklin, Laureen, Deitz, Jean, Jirikowic, Tracy, Astley, Susan (2008). Children with Fetal Alcohol Spectrum Disorders: Problem Behaviors and Sensory Processing. The American Journal of Occupational Therapy 62, 265-273 Comment: Results provide evidence that children with FASD demonstrate problem behaviors and sensory-processing impairments as reported by parents and that sensory-processing deficits co-occur with problem behaviors at a high rate in this population. This finding suggests that deficits in sensory processing may affect the ability of children with FASD to respond adaptively to their environments.

Koomar, J. A,(2009, December). Trauma-and attachment-informed sensory integration assessment and intervention. Sensory Integration Special Interest Section Quarterly, 32(4), 2. Comment: Highlights the importance of identifying and differentiating the root causes of over-arousal and shutdown.



SECTION IV: Select Articles on the Theory of Sensory Integration

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Kinnealey, M., Koenig, K.P., & Elchelberger Huecker, G. (1999). Changes in special needs children following intensive short-term intervention. The Journal of Developmental and Learning Disabilities. 3, 85-103. Comment: This study explored changes in neuro-motor functioning, behaviors, and sensory modulation of children with special needs following a week-long camp program (intensive model) focused on improving sensory integrative functioning. The program was effective in reducing soft-neurological signs, extremes of behaviors and behaviors associated with ADD.

May-Benson, T.A. & Koomar, J.A. (2010) Systematic review of the research evidence examining the effectiveness of interventions using a sensory integrative approach for children. American Journal of Occupational Therapy, 64, 403-414. Comment: This article provides a systematic review and analysis of 27 studies related to the effectiveness of sensory integration (SI) intervention on the ability of children to engage in daily occupations and to apply these findings to occupational therapy practice. Results of the review suggest that the SI approach may result in positive outcomes in multiple areas identified.

Miller, L.J., Coll, J.R., & Schoen, S.A. (2007). A randomized controlled pilot study of the effectiveness of occupational therapy for children with sensory modulation disorder. American Journal of Occupational Therapy, 61, 228-238. Comment: The study evaluated the effectiveness of three treatment groups of children with sensory modulation disorders. Findings suggest that OT-SI may be effective in treating children with sensory modulation disorders. The article addresses the complex conceptual and methodological issues related to researching this area of practice.

Wilbarger, J., Stackhouse, T.M. Sensory modulation: A review of the literature. Retrieved July 5, 2007 from www.OT-Innovations.com/content/view/29/58/ Comment: A 2007 brief literature review of the concept of sensory modulation within the field of occupational therapy. Provides contributions of occupational therapy professionals in operationalizing the concept of sensory modulation.



SECTION V: Websites that Provide Additional Support and References

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SECTION V

Websites that Provide Additional Support and References

www.AOTA.org

Comment: This PowerPoint presentation, titled Recess: An Important school routine (2013) is provided by AOTA as a resource to practitioners, advocates for the role of OT in promoting recess to support learning and social-emotional development/health. Membership required for access.

www.CanChild.ca Comment: The McMaster University Centre for childhood Disability Research has an entire section on Sensory Integration with extensive references.

www.OT-Innovations.com Comment: Tina Champagne’s website has a large amount of research and resources, including how to set up a sensory room, sensory diet handouts, and other valuable information.

www.SensoryConnectionProgram.com

Comment: This is a compilation of references and resources generated by Karen Moore and available on her website. The materials are directed with adults in mind but many have age-span possibilities.

www.SPDFoundation.net Comment: Sensory Processing Foundation provides research, education and advocacy around issues related to sensory processing disorder. The on-line “library” allows access to relevant published literature.

www.TheSpiralFoundation.org Comment: The Spiral Foundation of OTA Watertown is dedicated to helping children with sensory integration dysfunction lead full and productive lives. Their research section provides research related to the sensory processing.

AP Literature and Research - The Alert Program · TherapyWorks, Inc PO Box 95316 Albuquerque, NM...

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